Transtubular Evacuation of Hypertensive Intracerebral Hemorrhage with Limited Equipment

World Neurosurgery
Tao Xu, Tony Chor

Abstract

Hypertensive intracerebral hemorrhage is common in developing countries, where many patients with hypertension are not detected and well treated. The tubular retractor system provides the opportunity for surgeons to evacuate the clot and achieve hemostasis under direct vision. We showed a transtubular surgery performed in a developing country with limited equipment (Video 1). A 62-year-old man with a right-side basal ganglia hematoma was admitted. Head computed tomography showed the volume of the hematoma was 49.67 mL, and the Glasgow Coma Scale was 7 when admitting. After getting written consent from the patient's family, a transtubular evacuation of intracerebral hemorrhage was performed with headlight and surgical loupes. Left-side external ventricular drain was done first. A surgical tube was inserted through the right middle frontal gyrus to the base of the hematoma, gentle suction was applied to remove the clot, and hemostasis was achieved by bipolar coagulation and compression. Postoperative computed tomography scan confirmed a near total removal of the hematoma, with a clearance rate of 93.6%. The patient's postoperative Glasgow Coma Scale score was 12, and left upper and lower extremity movement improved to grade 4. Th...Continue Reading

Citations


❮ Previous
Next ❯

Related Concepts

Related Feeds

Basal Ganglia

Basal Ganglia are a group of subcortical nuclei in the brain associated with control of voluntary motor movements, procedural and habit learning, emotion, and cognition. Here is the latest research.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.